Effects of osseodensification protocol on insertion, removal torques, and resonance frequency analysis of BioHorizons® conical implants: An ex vivo study

Objective: Quantify the effect of the osseodensification Densah® protocol on the insertion torque, ISQ, and the removal torque of conical BioHorizons® implants. Materials and methods: An ex vivo model over fresh pig tibia bone was used. Test group (TG) included 50 osteotomies using Densah® osseodensification protocol, and the control group (CG), 50 osteotomies using BioHorizons®’s recommended procedure. Conical BioHorizons® implants (3.8 × 10.5 mm) were implanted, verifying the insertion torque with a manual torque meter. ISQ values were registered with Ostell® device. Finally, implants were removed with manual reverse torque registering the values. Results were analyzed and compared with the Mann-Whitney test and t-test. Results: Median and interquartile range per group were as follows: insertion torque, CG: 26 (12) Ncm; TG: 42 (26) Ncm, removal torque, CG: 25 (20) Ncm; TG: 40 (28) Ncm, ISQ value, CG: 69.25 (5.5); TG: 71.5 (4). All variables were significantly higher (p ≤ 0.05) in the osseodensification group. Conclusions: The Osseodensification technique may improve primary stability in the clinical scenario on tapered implants. Further human RCTs are necessary to validate this.